BACKGROUND: In case of carotid artery occlusion, the risk and extent of ischemic cerebral damage is highly dependent on the pathways of collateral flow, including the anatomy of the circle of Willis. In this report, cases are presented to illustrate that 4D-CTA can be considered as a non-invasive alternative to DSA for the evaluation of circle of Willis collateral flow. CASE DESCRIPTION: Five patients with unilateral internal carotid artery (ICA) occlusion underwent 4D-CTA for the evaluation of intracranial hemodynamics...

Many strains of mice are utilized in mouse models of cerebrovascular diseases. Variations in vascular anatomy between these strains has been documented and may influence the phenotype in stroke models. To address inter-strain variations in the circle of Willis anatomy, the diameters of internal carotid, posterior communicating, anterior cerebral, and middle cerebral arteries in 144 mice from 32 inbred strains were measured. Arterial diameters were analyzed as a function of animal weight, age, and strain. Variations in the structure of the circle of Willis across strains were observed and noted...

BACKGROUND: Identification and anatomic features of the feeding arteries of the arteriovenous malformations (AVMs) is very important due to neurologic, radiologic, and surgical reasons. MATERIALS AND METHODS: Seventy-seven patients with AVMs were examined by using a digital subtraction angiographic (DSA) and computerized tomographic (CT) examination, including 3D reconstruction of the brain vessels. In addition, the arteries of 4 human brain stems and 8 cerebral hemispheres were microdissected...

PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...

AIM: Anatomical variants of the circle of Willis are diverse and frequent and, although they are not a direct cause of cerebrovascular diseases, they are risk factors for impaired collateral perfusion and wall shear stress. This study aimed to correlate the anatomical variants with their effects on the hemodynamic and geometrical parameters responsible for the pathogenesis of neurological diseases. MATERIAL AND METHODS: The circle of Willis and the proximal segments of the main arteries were dissected and measured on ten formalin-fixed human brains...

The thalamus is a part of the diencephalon, containing numerous connections between the forebrain and subcortical structures. It serves an important function as a relay center between the cerebral cortex and the subcortical regions, particularly with sensory information. The thalamus also plays a major role in regulating arousal and the levels of awareness. Distinct vascular distribution of the thalamus give rises to different syndromic presentation of thalamic nuclei infarcts. The clinical records and available imaging studies of patients with confirmed thalamic territory infarcts on magnetic resonance imaging (MRI) at the University Hospital of Rochester were reviewed and analyzed...

The measurement of cerebral blood volume (CBV) has been the topic of numerous neuroimaging studies. To date, however, most in vivo imaging approaches can only measure CBV summed over all types of blood vessels, including arterial, capillary and venous vessels in the microvasculature (i.e. total CBV or CBVtot). As different types of blood vessels have intrinsically different anatomy, function and physiology, the ability to quantify CBV in different segments of the microvascular tree may furnish information that is not obtainable from CBVtot, and may provide a more sensitive and specific measure for the underlying physiology...

Nephrotic syndrome is a prothrombotic state with predisposition to venous sinus thrombosis and arterial vascular stroke. Watershed infarcts in junction of arterial territory develop in hypotensive hypovolemic state. These border zone infarcts are usually bilateral in the absence of unilateral arterial stenosis or microembolism. We report a 6-year-girl of frequently relapsing nephrotic syndrome who developed sudden onset hemiparesis with aphasia. Magnetic resonance (MR) imaging brain revealed unilateral watershed infarct in territory between the major cerebral arterial vessels with evidence of restricted diffusion and normal vessel anatomy on MR angiography...

Variations and anomalies of the posterior cerebral artery (PCA) have several clinical implications, including assisting in understanding the clinical signs of a stroke. Anomalies have been described previously; however, few reports mention the origins, absence, duplication and triplication of the cortical branches. Furthermore, the PCA branching pattern has not been adequately described. The aim of this study is to describe the anatomy and anomalies of the PCA. Results of a pilot study were additionally included...

Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included...

BACKGROUND: Anatomical variations of the middle cerebral artery (MCA) are an important clinical issue, due to high prevalence of intracranial aneurysms. Anatomical variations of vessels can lead to higher shear stress, which is thought to be the main factor leading to aneurysm formation and consequently to higher prevalence of aneurysms. The aim of this study was to evaluate anatomy of the MCA; to classify MCA aneurysms using CT angiography and to correlate anatomical variations of MCA and circle of Willis with prevalence of MCA aneurysms...

Schizophrenia is a severe mental disorder that affects the anatomy and function of the brain, with an impact on one's thoughts, feelings, and behavior. The purpose of the study was to investigate cerebral blood flow (CBF) and brain connectivity in a group of patients with schizophrenia. Pseudo-continuous arterial spin labeling (pCASL) images were acquired from 28 patients in treatment and 28 age-matched healthy controls. Mean CBF and connectivity patterns were assessed. Schizophrenia patients had decreased CBF in the bilateral frontal pole and superior frontal gyrus, right medial frontal gyrus, triangular and opercular parts of the inferior frontal gyrus, posterior division of the left supramarginal gyrus, superior and inferior divisions of the left lateral occipital cortex, and bilateral occipital pole...

Quantitative susceptibility mapping (QSM) has been recently introduced as a novel MRI post-processing technique of gradient recalled echo (GRE) data. QSM is useful in depicting both brain anatomy and for detecting abnormalities. Its utility in the context of ischemic stroke has, however, not been extensively characterized so far. In this study, we explored the potential of QSM to characterize vascular and tissue changes in the transient middle cerebral artery occlusion (tMCAO) mouse model of cerebral ischemia...

(Background) Intraorbital arteriovenous fistula is a very rare disease, therefore an optimal treatment strategy has not yet been established. Here we describe the use of high-resolution cone-beam CT (CBCT) and selective angiography to visualize the detailed anatomy of orbital vessels. The information provided by the intra-operative imaging led to a change in treatment strategy and eventually to successful transvenous coil embolization. (Clinical presentation) A 55-year-old man presented with right exophthalmos, chemosis and diplopia 4 months previously...

BACKGROUND: Entrapment of the temporal horn, known as isolated lateral ventricle (ILV), is a rare type of noncommunicating focal hydrocephalus, and its standard treatment has not been established. Here, we report two cases of endoscopic surgery for ILV, and highlight the anatomical surgical nuances to avoid associated surgical risks. CASE DESCRIPTION: The authors present two surgical cases with ILV treated by endoscopic surgery. The first patient with recurrent ILV, due to shunt malfunction, following the initial shunt placement for ILV...

BACKGROUND AND IMPORTANCE: Fusiform intracranial aneurysms remain challenging lesions to treat. These aneurysms have historically required bypass procedures or clip remodeling constructs for cure. Recently, endovascular specialists have reported experience with flow diversion for complex fusiform aneurysms of the vertebrobasilar system, with mixed results. Vascular anatomy for anterior circulation fusiform aneurysms may make these lesions more amenable to flow diversion and embolization procedures; however, published experience with these techniques is lacking...

BACKGROUND: Endovascular coil embolization is an accepted treatment option for intracranial aneurysms. However, the coiling of aneurysms with an incorporated artery (IA) poses a high risk of IA occlusion. Here we report our experience of endovascular coil placement using a technique that avoids IA occlusion in aneurysms with IAs. METHODS: Over a 6-year period, 185 patients harboring 206 intracranial aneurysms underwent endosaccular coiling. Forty-two of these patients with 45 aneurysms were treated by coil placement to avoid IAs occlusion...

BACKGROUND: The middle temporal artery (MTA) is the proximal medial branch of the superficial temporal artery (STA), supplying the temporalis muscle along with deep temporal arteries. Its use in vascularized flaps for reconstructive and otologic procedures has been described, yet its potential use in neurosurgery has not been studied. We report a novel technique for exposing the MTA and evaluated its characteristics for extracranial-intracranial cerebrovascular bypass. METHODS: After a curvilinear frontotemporal incision in 10 cadaveric specimens, the STA was dissected from distal to proximal...